Behavior therapy helps combat severe fatigue after Covid-19

People who experience chronic, severe fatigue after Covid-19 may benefit from cognitive behavioral therapy. Dutch research shows that about 60 percent of patients who followed the treatment were clearly tired after 17 weeks of treatment. They could concentrate better, and other physical complaints also decreased. That effect was still measurable six months later. The study appeared Monday in the journal Science Clinical Infectious Diseases.

“The findings are consistent with what we see in breast cancer and other diseases with severe persistent fatigue, such as multiple sclerosis (MS) and type 1 diabetes,” says Hans Knoop, professor of clinical psychology at Amsterdam UMC. . “Cognitive behavioral therapy has a positive effect on some people with fatigue in those disorders.”

The study involved 114 people with persistent severe fatigue 3 to 12 months after experiencing Covid-19. Almost everyone was infected before vaccination. Half of them received cognitive behavioral therapy, while the other half received usual care: supervision by a general practitioner or specialist, physiotherapy and, if necessary, occupational therapy.

A different feeling

One of the participants, Wendy van Iberen (52), is the owner of a clothes shop in the quiet Zeeland and Capell. “I’ve had Covid-19 for three weeks and I’m not getting better. After working in my shop for two hours, my legs are mush, the lights go out, and then I have to lie down and sleep. It’s a strange feeling, I’m self-employed and I’ve never been sick. A Facebook post for this study When I saw the ad, I immediately called and first asked what cognitive behavioral therapy was, because it wasn’t really on my mind. Van Iberen decided to participate. “I wanted to get my shop running again and take care of my horses.”

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Participants’ treatment consisted of online modules and an average of twelve interactions with a psychologist, via email, phone, video call, or face-to-face.

Cognitive behavioral therapy didn’t work for everyone, but it did work for the majority: 60 percent of participants didn’t become seriously fatigued afterward. In the control group, it was present in only 27 percent of patients. Patients who received the treatment were able to concentrate better, work better, see friends doing better, and had more trouble breathing and sleep problems than the control group.

Surrendered himself

Follow-up studies will need to show whether these findings are applicable to a wider population – one that mainly includes post-Covid patients who were not hospitalized for Covid-19 and self-administered patients.

Van Ibern also recovered. “I had to get in and out of bed at certain times and I was allowed to rest during the day but never sleep again. It was very difficult. I always learned to listen to your body, but not anymore. For example, weekly contact with the psychologist about how your environment responded to your complaints.

She also learned to measure her energy. “At first I had to walk five minutes a day, and whenever I could, I was allowed to build up to five minutes. Now, after seven months of treatment, I have returned to full-time work, and I take care of my horses and work in the garden in the evenings. I still have shortness of breath from time to time. The stuttering is there but completely cured.I never thought that cognitive behavioral therapy can help with these types of complaints.

If you think something is permanently broken, it will have an impact

Hans Button Prof

This study did not provide an explanation for the positive effect. But Knoop has an idea: “In this study we think that a disease like Covid-19 causes fatigue, and sometimes it is partially maintained by certain attitudes or habits. This could be a disturbed sleep pattern or the way activities are distributed throughout the day.

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How one feels about fatigue and pain can also play a role, says Noob. “For example, if you think something is permanently broken because of an infection and you’ll never recover, that can have an impact.”

Noob is glad to clear up a widespread misunderstanding. “Just because cognitive behavioral therapy can help post-Covid fatigue doesn’t mean there’s a psychological cause or a physical cause. It’s important that we continue to look for a biological cause.”

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